Director of Medical Policy

DescriptionThe Director of Medical Policy works with the Medical Strategy and Knowledge Advancement team, Sales, and Field Reimbursement team to pursue payor contacts to maximize insurance coverage and payment rates for Kerecis products. In this role, the Director reviews Payor Policy cycles and payment rate negotiations, and works with Clinical Affairs to extend Kerecis insurance coverage. The role works in close collaboration with the Medical Affairs, Market Access, Field Reimbursement, and Benefits Investigations teams to execute strategic plans.This position works in a Kerecis office and directly reports to the Senior Vice President of Medical Strategy and Knowledge Advancement.Responsibilities

Manage a strategy to engage Private Payers, Medicare and Medicaid, and other strategic payor organizations to expand coverage and access to Kerecis technologies.Document the actions from internal Policy meetings, follow up, and hold accountable the assigned task managers.Manage tasks assigned to consultants.Attend the Alliance for Wound Care Stakeholders meetings, document the meetings, send notes internally, manage medical policy reviews, contract additions, and requests.Identify opportunities for innovative partnerships with private insurers and other strategic healthcare organizations.Develop and maintain high-value relationships with key decision makers.Maintain thorough knowledge of political climate, market trends, and contracting needs.Conduct regular business reviews with private insurers.Consult on market access and reimbursement strategy for new and emerging products.Support Medical Strategy and Knowledge Advancement in Training events.Work cross-functionally within Kerecis to achieve MBO targets and goals.Other duties and tasks as assigned.Requirements

Competencies

Strong project management, presentation, communication, and financial analysis skills.Relevant scientific, technical, and consultative sales training.Ability to work effectively with cross-functional teams in a fast-paced, multi-dimensional organization.Superior communication and presentation skills.Education & Experience

Bachelor’s degree in a Scientific or Business discipline.3 years related experience in healthcare medical device industry.Track record of successfully working with health care payors and other strategic healthcare organizations.Relevant advanced degrees and/or healthcare certifications, preferred.Proven track record of working for or with health care payors and other strategic healthcare organizations.Strong established relationships with hospitals in a designated area.Travel: frequent (50%)This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time. Kerecis LLC is an equal opportunity employer.

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